Patella fracture reduction plates

ABSTRACT

Plates for patella fracture reduction and fracture reduction devices are described. More particularly plates and devices for patella reduction that are universally fit to a front surface or perimeter of a patella and include a plurality of attachment holes disposed therein for receiving a fastener. In some embodiments, the plates include removable tab members.

PRIORITY APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.15/294,528, filed Oct. 14, 2016, which claims the benefit of priority toU.S. Provisional Application Ser. No. 62/241,863, filed Oct. 15, 2015,the content of each of which is incorporated hereby by reference in itsentirety.

BACKGROUND

Fracture reduction devices are known in the art. For long bones, such asthe femur, tibia, and fibula, fractures can potentially be reduced usingplating systems. For bony areas where the bone includes curvature inmultiple axes, and areas where the skin is especially taut to the bone,use of plating systems can be challenging. In such bony areas, such asthe patella, other reduction methods have been employed. One such methodor system includes high tension mesh plates. Another approach used inthe prior art includes wiring or cord systems. In the case of meshapparatuses, the systems generally require the surgeon to cut the meshplate to size and fit the mesh for a give patient's patella. Wiring andcabling systems generally require the surgeon to route the wires orcables through channels created in the patella, and/or require thesurgeon to wrap the wire or cable around at least a portion of thepatella.

SUMMARY

This section provides a general summary of the disclosure, and is not acomprehensive disclosure of its full scope or all of its features.

The present inventors have recognized, among other things, that aproblem to be solved is providing a fracture reduction system for thepatella that does not require time to individually fit the system forindividual patients before or during operation. It would also bedesirable to have a system that does not require wire in order to createtension across a fracture, while still maintaining a low profilesolution. The present disclosure can help provide a solution to theseproblems with a strong, flexible plate that is generally a universal fitfor patellas of various patients. The system further can provide asolution by utilizing a monolithic plate that does not require the useof wires in order to reduce the fracture (though wires can be used withthe presently described system where appropriate and desirable).

The present disclosure includes a first device for patella fracturereduction. The device can include a patellar plate body formed from amonolithic material. The patellar plate body can comprise a centralportion and a peripheral portion at least partially surrounding thecentral portion. The central portion can include a plurality of plateattachment holes disposed therein. The peripheral portion can comprise aplurality of tabs. Each of the plurality of tabs can be coupled to thecentral portion via a connector portion that is less than about 80% of aplate thickness of the patellar plate body. Each tab can include a tabattachment hole disposed therein. Each tab can be selectively detachablefrom the patellar plate body. The patellar plate body can be contouredto fit substantially any patella.

The present disclosure includes a second device for patella fracturereduction. The fracture reduction device can include a curved perimeterplate contoured to a perimeter of substantially any patella. The curvedperimeter plate can define a plate length between a first end and asecond end thereof that extends along at least a portion of theperimeter of a patella. The curved perimeter plate can include aplurality of connection regions positioned along the plate length and aplurality of securing regions positioned along the plate length. Atleast some of the connection regions can be positioned between twoadjacent securing regions. Each securing region can include anattachment hole disposed therein.

The present disclosure further includes systems comprising a patellarplate body and a curved perimeter plate. Such systems can furthercomprise at least one guide insert removably disposed in at least one ofa patellar plate attachment hole, a tab attachment hole, and a perimeterplate attachment hole.

Further areas of applicability will become apparent from the descriptionprovided herein. The description and specific examples in this summaryare intended for purposes of illustration only and are not intended tolimit the scope of the present disclosure.

DESCRIPTION OF THE DRAWINGS

The drawings described herein are for illustrative purposes only ofselected embodiments and not all possible implementations, and are notintended to limit the scope of the present disclosure.

FIG. 1A illustrates a top view of a plate for patella fracturereduction, in accordance with at least one example of the presentdisclosure.

FIG. 1B illustrates a perspective view of a plate for patella fracturereduction, in accordance with at least one example of the presentdisclosure.

FIG. 1C illustrates a side view of a plate for patella fracturereduction, in accordance with at least one example of the presentdisclosure.

FIG. 2 illustrates a front view of a plate for patella fracturereduction positioned on the surface of a patella, in accordance with atleast one example of the present disclosure.

FIG. 3A illustrates a perspective view of a fracture reduction device,in accordance with at least one example of the present disclosure.

FIG. 3B illustrates a top view of a fracture reduction device, inaccordance with at least one example of the present disclosure.

FIG. 4 illustrates a front view of a patella with a fracture reductiondevice positioned on the perimeter of a patella, in accordance with atleast one example of the present disclosure.

FIG. 5A illustrates a perspective of a fracture reduction device, inaccordance with at least one example of the present disclosure.

FIG. 5B illustrates a top view of a fracture reduction device, inaccordance with at least one example of the present disclosure.

FIG. 6 illustrates a front view of a patella with a fracture reductiondevice positioned on the perimeter of the patella, in accordance with atleast one example of the present disclosure.

FIGS. 7A-7B provide perspective views of a fracture reduction devicewith alignment guides, in accordance with at least one example of thepresent disclosure.

FIG. 7C illustrates a close-up view of a fracture reduction device withalignment guides and a securing element, in accordance with at least oneexample of the present disclosure.

FIG. 8A illustrates a perspective view of a fracture reduction device,in accordance with at least one example of the present disclosure.

FIG. 8B illustrates a side view of a fracture reduction device, inaccordance with at least one example of the present disclosure.

FIG. 8C illustrates a top view of a fracture reduction device, inaccordance with at least one example of the present disclosure.

DETAILED DESCRIPTION

Example embodiments will now be described more fully with reference tothe accompanying drawings.

The present disclosure provides for devices and systems for reducingfractures of the patella including plates. FIGS. 1A-1C illustrate top,perspective and side views of one exemplary plate for patella fracturereduction according to the present disclosure. Plate 100 can include apatellar plate body 102. Patellar plate body 102 can be, in someexamples, contoured to conform to a curved surface of substantially anypatella and can extend across at least one fracture in the patella.Alternatively or additionally, plate body 102 can extend across two,three or more fractures on the patella in close proximity to oneanother. Patellar plate body 102 can be formed from a monolithicmaterial and, additionally or alternatively, can comprise a centralportion 107 and a peripheral portion 108 at least partially surroundingthe central portion 107. The central portion 107 can include a pluralityof plate attachment holes 104 disposed therein. The plate attachmentholes 104 can receive a securing element, such as, for example andwithout limitation, a locking screw, a non-locking screw, and the like.

The peripheral portion 108 of the plate 100 can comprise a plurality ofselectively removable tabs 106. Each tab 106 can be coupled to thecentral portion 107 via a connector portion 109 that can have athickness that is less than about 80% of a plate thickness of thepatellar plate body 102. As a result of the reduced thickness, the tabcan be more easily removed. At least some of tabs 106 can include a tabattachment hole 110 disposed therein. Each tab 106 can be selectivelydetached by, for example and without limitation, bending, deformation,and the like. Each tab attachment hole 110 can receive a securingelement in the same fashion as attachment holes 104. In any one orcombination of the cases that a tab 106 is not filled with a securingelement, poses no benefit, causes overhang, exceeds the surface of thebone, etc., the surgeon can remove the tab member 106. Tab members 106can be cleanly removed using a few bending cycles or clipping the tabmembers off with, e.g., plate cutters or a wire cutter.

Plate attachment holes 104 and tab attachment holes 110 can be sized andshaped to receive a securing element in order to secure at least aportion of the plate 100 to the surface of the patella. As shown in FIG.1 and in other figures herein, any one of the attachment holes can beround, such as circular or oval, although other shapes (e.g., square,hexagonal, etc.) are also contemplated.

Patellar plate body 102 can comprise any number of suitable shapes. Inan example, as illustrated in FIG. 1A, plate body 102 can comprise apentagonal shape (as illustrated by dashed line pentagon 112). Inanother example, the plate body 102 can have the shape of an upside-downpear or a tear. In another example, the patellar plate body can be sizedand shaped in a horizontal and vertical direction, and, additionally oralternatively, three-dimensionally contoured to fit a patella and, moreparticularly, universally fit any patella. Patellar plate body 102 canalso include any suitable number of plate attachment holes 104 and tabattachment holes 110 (collectively referred to as “attachment holes”)necessary to sufficiently secure the plate 100 to the patella and aid inreducing a fracture of the patella. In various examples, the plate body102 can include at least four attachment holes, at least six attachmentholes, at least eight attachment holes, at least ten attachment holes,or more. Attachment holes 104, 110 can accept a securing element thatcan have a diameter of between about 2.0 mm and about 3.0 mm. In anexample, attachment holes 104 can accept a 2.5 mm screw. The securingelement can be any suitable fastening member, such as a locking screw, anon-locking screw, or the like. Patellar plate body 102 can be, in anexample, made of a material that is moldable to a curved shape but alsostrong. For example, plate body 102 can be made of titanium or atitanium alloy. In an example, the plate 100 can be monolithic and boththe central portion 107 and the peripheral portion 108 can be titaniumor a titanium alloy.

Patellar plate body 102 can have a low profile such that it does notextend a great distance away from the surface of the patella afterimplantation. In various examples, plate body 102 can have a thicknessof less than about 3 mm, less than about 2 mm thick, or less than about1.6 mm thick. An illustration of plate 100 positioned over the frontsurface of a patella 10 is provided in FIG. 2.

In another example illustrated in FIGS. 3A-3B, the present disclosurerelates to a second fracture reduction device. Fracture reduction device200 can comprise a curved perimeter plate 202 that can be, in variousexamples, contoured to a perimeter of substantially any patella. Thecurved perimeter plate 202 can define a plate length L between a firstend 214 and a second end 216 thereof that extends along at least aportion of the perimeter of a patella. The plate 202 can comprise aplurality of connection regions 218 that can be positioned along theplate length L and a plurality of securing regions 220 positioned alongthe plate length. At least some (or potentially all) of the connectionregions 218 can be positioned between two adjacent securing regions 218.Each securing region 220 can include an attachment hole 222 disposedtherein. As with patellar plate body 102 above, the curved perimeterplate 202 can have a low profile, e.g., the plate can have a thicknessof less than 3.0 mm, less than 2.0 mm, or less than 1.6 mm.

In an example illustrated in FIGS. 3A and 3B, the curved perimeter plate202 can be configured to extend along greater than about one-third ofthe perimeter of the patella and less than about two-thirds of theperimeter of the patella. For example, the plate 202 can extend alongapproximately one-half of the perimeter of the patella. An example of ahalf-perimeter fracture device 200 positioned on the perimeter of apatella 10 is illustrated in FIG. 4. Alternatively, as illustrated withfracture reduction device 300 of FIGS. 5A and 5B, a curved perimeterplate 302 can extend along greater than about one-fifth of the perimeterof the patella and less than about one-third of the perimeter of thepatella. For example plate 302 can extend along approximatelyone-quarter of the perimeter of the patella. An example of aquarter-perimeter fracture device 300 positioned on the perimeter of apatella 10 is illustrated in FIG. 6.

One benefit of all presently described fracture reduction devices isthat the devices can be universal to substantially any patella and suchthat they are not left/right, top/bottom side, or medial/lateralspecific. For example, the curvature of the devices can be such thatthey can generally be positioned on either the medial or lateral side ofthe patella, and, with regard to the perimeter plates, on the top sideor bottom side of the patella along the perimeter.

Returning to FIGS. 3A and 3B, as with the example described in FIGS.1A-1C, the attachment holes 222 of curved perimeter plate 202 can accepta securing device, such as a screw, that can have a diameter of betweenabout 2.0 mm and about 3.0 mm. In an example, the attachment holes 222can accept a screw having a diameter of 2.5 mm. The curved perimeterplate 202 can include at least four attachment holes, at least sixattachment holes, at least eight attachment holes, or more. Curvedperimeter plate 202 can be, in an example, made of a material that ismoldable to a curved shape but also strong. For example, curvedperimeter plate 202 can be made of titanium or a titanium alloy.

In various examples, any of the presently described fracture reductiondevices can be used with a guide system that can aid in accurateplacement of the plate 102, 202 on the patella. An example of a guidesystem is illustrated in FIGS. 7A-7C. Attachment holes 222 of fracturereduction device 200 can receive guide inserts 703. Guide inserts 703can be placed into attachment holes 222 prior to the securing elementbeing inserted through the attachment holes. The guide inserts 703 canalso define a trajectory for the securing element through the attachmenthole. Once the appropriate alignment of the fracture device 200 has beenachieved relative to the patella, the guide inserts 703 can be removed.After a given guide insert 703 is removed, a corresponding securingelement can be inserted into the attachment hole 703 in order tosecurely affix the fracture device 200 to the patella. FIG. 7Aillustrates a first exemplary guide insert 703 a being removed from anattachment hole 222. FIG. 7B illustrates a next step in which a securingelement 705 can be inserted into the first attachment hole 222 a afterthe first guide insert has been removed from the hole. The other guideinserts 703 can be left in respective attachment holes 222 duringinsertion of securing devices into adjacent attachment holes (e.g. 222a) in order to ensure that the fracture device remains appropriatelypositioned. FIG. 7C illustrates the construction with securing element7505 fully inserted through attachment hole 222 and into the patella.Though shown in FIGS. 7A-7C with respect to fracture reduction device200 configured for use on the perimeter of the patella, the plate 100 ofFIGS. 1A-1C can also be designed such that attachment holes 104 areconfigured to receive guide inserts of the type described herein.

In another example, as illustrated in FIGS. 8A-8C, a fracture reductiondevice 400 comprising a plate 402 can include at least two anchor holes424, such as anchor holes 424 a and 424 b. FIGS. 8A-8C furtherillustrate that the plate 402 can also include selectively removabletabs 406 as described above with respect to tabs 106. At least one ofthe tabs 406 can include a tab attachment hole 410 disposed therein.Alternatively, multiple or each of the tab members 406 can include a tabattachment hole 410 disposed therein. Tab attachment hole(s) 410 canaccept a securing element.

In an example illustrated in FIG. 9, a fracture reduction device havinganchor holes disposed therein (e.g., device 400) can be secured at leastpartially via a wire to the patella to aid in fracture reduction. Here,wire 530 can be routed from the first anchor hole 424 a through a firstlength of the patella L₁ along a first path. The wire 530 can bepositioned along an exterior length of the perimeter of the patella L₂.The exterior length of the perimeter of the patella L₂ can be positionedon the opposite side of the patella 540 from the plate 402. The wire 530can further be routed through a second length of the patella L₃ along asecond path and secured to the second anchor hole 424 b. The wire 530can be tensionable to aid in reduction of the patella fracture.

Alternatively, other types of securing devices can be used to secure theanchor holes to the patella. For example, the anchor holes can beconfigured to receive sutures that can be secured to the patella and tothe anchor holes to create tension across the patella fracture.Additionally or alternatively, the anchor holes can be used to anchor abraided fixation system, for example, a braided polyethylene fixationsystem such as the Zimmer Biomet ZipLoop™ Technology (Zimmer Biomet,Warsaw, Ind.) that creates tension with an opposing edge of the patella.

VARIOUS NOTES & EXAMPLES

Example 1 is a device that can comprise a patellar plate body that canbe formed from a monolithic material and can comprise a central portionand a peripheral portion at least partially surrounding the centralportion. The central portion including a plurality of plate attachmentholes disposed therein, and the peripheral portion can comprise aplurality of tabs. Each tab can be coupled to the central portion via aconnector portion that has a thickness that is less than about 80% of aplate thickness of the patellar plate body. Each tab can include a tabattachment hole disposed therein. Each tab can be selectively detachablefrom the patellar plate body. The patellar plate body can be sized in atleast a horizontal and a vertical direction to fit a patella.

In Example 2, the subject matter of Example 1 can optionally include thecentral portion comprising a pentagonal shape.

In Example 3, the subject matter of any one or more of Examples 1-2 canoptionally include one plate attachment hole or one tab attachment holethan can accept a screw having a diameter of between about 2.0 mm andabout 3.0 mm.

In Example 4, the subject matter of any one or more of Examples 1-3 canoptionally include wherein the plate body includes at least sixattachment holes.

In Example 5, the subject matter of any one or more of Examples 1-4 canoptionally include wherein the plate body includes at least eightattachment holes.

In Example 6, the subject matter of any one or more of Examples 1-5 canoptionally include wherein the monolithic material comprises titanium ora titanium alloy.

In Example 7, the subject matter of any one or more of Examples 1-6 canoptionally include wherein the patellar plate body is less than about3.0 mm thick.

In Example 8, the subject matter of any one or more of Examples 1-7 canoptionally include wherein the patellar plate body is less than about2.0 mm thick.

In Example 9, the subject matter of any one or more of Examples 1-8 canoptionally include wherein the patellar plate body is less than about1.6 mm thick.

In Example 10, the subject matter of any one or more of Examples 1-9 canoptionally include wherein each of the plate attachment holes furthercomprises a guide insert for aiding in initially securing the patellarplate body to the patella prior to a securing element being insertedthrough a respective one of the plate attachment holes.

In Example 11, the subject matter of Example 10 can optionally includewherein the guide insert is removable prior to inserting the securingelement through the respective one of the plate attachment holes.

In Example 12, the subject matter of any one or more of Examples 1-11can optionally include wherein the securing element is a locking screwor a non-locking screw.

Example 13 is a device comprising: a curved perimeter plate contoured toa perimeter of substantially any patella and defining a plate lengthbetween a first end and a second end thereof that extends along at leasta portion of the perimeter of a patella, the perimeter plate comprisinga plurality of connection regions positioned along the plate length anda plurality of securing regions positioned along the plate length,wherein at least some of the connection regions are positioned betweentwo adjacent securing regions, and wherein each securing region includesan attachment hole disposed therein.

In Example 14, the subject matter of Example 13 can optionally includewherein the curved perimeter plate extends along at least aboutone-fifth of the perimeter of the patella and less than about one-thirdof the perimeter of the patella.

In Example 15, the subject matter of any one or more of Examples 13-14can optionally include wherein the plate extends along at least aboutone-third of the perimeter of the patella and less than about two-thirdsof the perimeter of the patella.

In Example 16, the subject matter of any one or more of Examples 13-15can optionally include wherein at least one of the securing regionsincludes an attachment hole that

In Example 17, the subject matter of any one or more of Examples 13-16can optionally include wherein the curved perimeter plate includes atleast six attachment holes.

In Example 18, the subject matter of any one or more of Examples 13-17can optionally include wherein the curved perimeter plate comprisestitanium or a titanium alloy.

In Example 19, the subject matter of any one or more of Examples 13-18can optionally include wherein each of the attachment holes furthercomprises a guide insert for aiding in initially securing the curvedperimeter plate to the patella prior to a securing element beinginserted through a respective one of the attachment holes.

In Example 20, the subject matter of Example 19 can optionally includewherein the guide insert is removable prior to inserting the securingelement through the respective one of the attachment holes.

In Example 21, the subject matter of any one or more of Examples 13-20can optionally include wherein the plate further includes at least twoanchor holes disposed therein.

In Example 22, the subject matter of Example 21 can optionally include awire routable from a first anchor hole of the at least two anchor holesthrough a first length of the patella along a first path disposed alongan exterior length of the perimeter of the patella, the exterior lengthof the perimeter of the patella being positioned on the opposite side ofthe patella from the plate, and routed back through a second length ofthe patella along a second path and secured to a second anchor hole ofthe at least two anchor holes, wherein the wire is selectivelytensionable.

Example 23 is a system that can comprise a patellar plate body and acurved perimeter plate. A patellar plate body can be formed from amonolithic material and can comprise a central portion and a peripheralportion at least partially surrounding the central portion. The centralportion including a plurality of plate attachment holes disposedtherein, and the peripheral portion can comprise a plurality of tabs.Each tab can be coupled to the central portion via a connector portionthat has a thickness that is less than about 80% of a plate thickness ofthe patellar plate body. Each tab can include a tab attachment holedisposed therein. Each tab can be selectively detachable from thepatellar plate body. The patellar plate body can be sized in at least ahorizontal and a vertical direction to fit a patella. A curved perimeterplate contoured to a perimeter of substantially any patella and defininga plate length between a first end and a second end thereof that extendsalong at least a portion of the perimeter of a patella, the perimeterplate comprising a plurality of connection regions positioned along theplate length and a plurality of securing regions positioned along theplate length, wherein at least some of the connection regions arepositioned between two adjacent securing regions, and wherein eachsecuring region includes an attachment hole disposed therein.

Each of these non-limiting examples can stand on its own, or can becombined in various permutations or combinations with one or more of theother examples. In the examples, the terms “a” and “the” are usedinterchangeably, such that reference to “the plate” in a given examplecan refer to a plate described in a previous example that is optionallycombined with the given example, or can refer to a separate tetherentirely. Similarly “a plate” can refer to a newly introduced plate, orto a plate described in a previous example.

The above detailed description includes references to the accompanyingdrawings, which form a part of the detailed description. The drawingsshow, by way of illustration, specific embodiments in which theinvention can be practiced. These embodiments are also referred toherein as “examples.” Such examples can include elements in addition tothose shown or described. However, the present inventors alsocontemplate examples in which only those elements shown or described areprovided. Moreover, the present inventors also contemplate examplesusing any combination or permutation of those elements shown ordescribed (or one or more aspects thereof), either with respect to aparticular example (or one or more aspects thereof), or with respect toother examples (or one or more aspects thereof) shown or describedherein.

In the event of inconsistent usages between this document and anydocuments so incorporated by reference, the usage in this documentcontrols.

In this document, the terms “a” or “an” are used, as is common in patentdocuments, to include one or more than one, independent of any otherinstances or usages of “at least one” or “one or more.” In thisdocument, the term “or” is used to refer to a nonexclusive or, such that“A or B” includes “A but not B,” “B but not A,” and “A and B,” unlessotherwise indicated. In this document, the terms “including” and “inwhich” are used as the plain-English equivalents of the respective terms“comprising” and “wherein.” Also, in the following claims, the terms“including” and “comprising” are open-ended, that is, a system, device,article, composition, formulation, or process that includes elements inaddition to those listed after such a term in a claim are still deemedto fall within the scope of that claim. Moreover, in the followingclaims, the terms “first,” “second,” and “third,” etc. are used merelyas labels, and are not intended to impose numerical requirements ontheir objects.

The above description is intended to be illustrative, and notrestrictive. For example, the above-described examples (or one or moreaspects thereof) may be used in combination with each other. Otherembodiments can be used, such as by one of ordinary skill in the artupon reviewing the above description. The Abstract is provided to complywith 37 C.F.R. § 1.72(b), to allow the reader to quickly ascertain thenature of the technical disclosure. It is submitted with theunderstanding that it will not be used to interpret or limit the scopeor meaning of the claims. Also, in the above Detailed Description,various features may be grouped together to streamline the disclosure.This should not be interpreted as intending that an unclaimed disclosedfeature is essential to any claim. Rather, inventive subject matter maylie in less than all features of a particular disclosed embodiment.Thus, the following claims are hereby incorporated into the DetailedDescription as examples or embodiments, with each claim standing on itsown as a separate embodiment, and it is contemplated that suchembodiments can be combined with each other in various combinations orpermutations. The scope of the invention should be determined withreference to the appended claims, along with the full scope ofequivalents to which such claims are entitled.

What is claimed is:
 1. A method for securing a patella fracturereduction plate, the method comprising: securing a wire to a firstanchor hole of a curved perimeter plate, the curved perimeter plateshaped to be contoured to a perimeter of substantially any patella, thecurved perimeter plate defining a plate length between a first end ofthe curved perimeter plate and a second end of the curved perimeterplate, the plate length configured to extend along at least a portion ofa perimeter of a patella, the curved perimeter plate including aplurality of connection regions positioned along the plate length, thecurved perimeter plate including a plurality of securing regionspositioned along the plate length, at least some of the connectionregions being positioned between two adjacent securing regions, eachsecuring region including an attachment hole disposed therein; routingthe wire along a first length of the perimeter of the patella; andsecuring the wire to a second anchor hole of the curved perimeter plate.2. The method of claim 1, wherein: the first anchor hole is positionedin a first connection region, of the plurality of connection regions,the second anchor hole is positioned in a second connection region, ofthe plurality of connection regions, different from the first connectionregion.
 3. The method of claim 1, wherein the first length of theperimeter of the patella is positioned along an exterior length of theperimeter of the patella.
 4. The method of claim 3, wherein the exteriorlength of the perimeter of the patella is positioned on an opposite sideof the patella from the curved perimeter plate.
 5. The method of claim1, further comprising: routing the wire along a second length of theperimeter of the patella, different from the first length of theperimeter of the patella.
 6. The method of claim 1, further comprising:tensioning the wire.
 7. The method of claim 1, wherein the first anchorhole and the second anchor hole are smaller in diameter than theattachment holes of the securing regions.
 8. The method of claim 1,further comprising: securing the curved perimeter plate to the patellaby applying a securing device through a first attachment hole of thecurved perimeter plate.
 9. The method of claim 8, further comprising:prior to applying the securing device through the first attachment hole,removing a guide insert from the first attachment hole of the curvedperimeter plate.
 10. The method of claim 8, wherein the securing deviceis a screw having a diameter between two millimeters and threemillimeters.
 11. The method of claim 1, wherein the curved perimeterplate is configured to extend along at least one-fifth of the perimeterof the patella and less than one-third of the perimeter of the patella.12. The method of claim 1, wherein the curved perimeter plate isconfigured to extend along at least one-third of the perimeter of thepatella and less than two-thirds of the perimeter of the patella. 13.The method of claim 1, wherein the curved perimeter plate includes atleast six attachment holes.
 14. The method of claim 1, wherein thecurved perimeter plate comprises titanium or a titanium alloy.
 15. Amethod for securing a patella fracture reduction plate, the methodcomprising: comparing a size of a patellar plate body to a patella, thepatellar plate body formed from a monolithic material, the patellarplate body including a central portion, the patellar plate bodyincluding a peripheral portion at least partially surrounding thecentral portion, the central portion including a plurality of plateattachment holes extending through the central portion, the peripheralportion including a plurality of tabs, each tab coupled to the centralportion via a connector portion, each tab being selectively detachablefrom the patellar plate body; determining that the patellar plate bodyis larger than the patella; and detaching at least one tab from thepatellar plate body, such that the patellar plate body, with the atleast one tab removed, is sized to match a size of the patella.
 16. Themethod of claim 15, wherein the central portion includes a pentagonalshape.
 17. The method of claim 15, further comprising: securing thepatellar plate body to the patella by applying a securing device througha first attachment hole of the patellar plate body.
 18. The method ofclaim 17, further comprising: prior to applying the securing devicethrough the first attachment hole, removing a guide insert from thefirst attachment hole of the patellar plate body.
 19. A method forsecuring a patella fracture reduction plate, the method comprising:securing a wire to a first anchor hole of a curved perimeter plate, thecurved perimeter plate shaped to be contoured to a perimeter ofsubstantially any patella, the curved perimeter plate defining a platelength between a first end of the curved perimeter plate and a secondend of the curved perimeter plate, the plate length configured to extendalong at least a portion of a perimeter of a patella, the curvedperimeter plate including a plurality of connection regions positionedalong the plate length, the curved perimeter plate including a pluralityof securing regions positioned along the plate length, at least some ofthe connection regions being positioned between two adjacent securingregions, each securing region including an attachment hole disposedtherein; routing the wire along a first length of the perimeter of thepatella, the first length of the perimeter of the patella beingpositioned along an exterior length of the perimeter of the patella onan opposite side of the patella from the curved perimeter plate;securing the wire to a second anchor hole of the curved perimeter plate;removing a guide insert from a first attachment hole of the curvedperimeter plate; and securing the curved perimeter plate to the patellaby applying a screw through the first attachment hole of the curvedperimeter plate.